What you need to know about your BCG treatment - WCMICS

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What you need to know about your BCG treatment
This fact sheet covers information about BCG treatment and special instructions
for you to follow before and after treatment. If you have any questions or concerns
about this information, please discuss them with your treatment team.
What is BCG?
BCG is a vaccine that is normally used to treat tuberculosis (TB). BCG is also used to
treat bladder cancer on the surface of the bladder wall. The exact way it works for
treating bladder cancer is not quite known. It seems that when BCG is inserted into the
bladder it causes a reaction that stimulates the body’s immune system (inflammatory
response) to destroy cancer.
Why do I need BCG treatment?
You have been prescribed this treatment for your bladder cancer.
How often do I have BCG treatment?
BCG treatment is given once a week for 6 weeks or as arranged by your doctor.
How is BCG given?
BCG is given directly into your bladder. A small tube (urinary catheter) is placed into
your bladder to drain the urine. The BCG solution is then inserted into your bladder
through this catheter.
How long will I need to stay at the hospital?
You will be at the hospital for about 4 hours in total.
What happens before my treatment?
You will have an appointment with your nurse prior to the treatment starting. At this
appointment you will be given information about your treatment. You can discuss any
concerns you may have and ask any questions. You will receive your treatment
appointment dates and be given a slip to have a blood test (FBE- full blood
examination), and six (6) urine sample request slips (MSU). You must have your blood
and urine test before your BCG treatment starts. Then, every Friday before your next
treatment you need to have your urine tested. Your following treatments may be given
or postponed for a week or longer depending on the result of these urine tests.
What will happen on the day of my treatment?
Do not have anything to drink for 4 hours before your treatment.
When you arrive at the hospital go to the Admissions and Registration Reception. After
you have registered proceed to Pathology Desk and check in with the receptionist. The
urology nurse will meet you there, and check your temperature, pulse and blood
pressure. It is important to tell the nurse if you have experienced any new urinary
symptoms.
You will be asked to pass urine before BCG treatment is started. A small tube (urinary
catheter) is placed into your bladder to drain any remaining urine. The BCG solution is
then inserted into your bladder through this catheter.

The BCG needs to stay in your bladder for 2 hours. During this time you will be lying
down. You will be asked to change your position, from back, R) side, tummy, L) side so
that the BCG covers all sides of your bladder. After 2 hours the BCG is drained from
your bladder and the catheter removed. You will be asked to try and pass urine before
you can go home. When you are feeling okay you may go home.
When your treatment is finished the nurse will give you a symptom scoring sheet for
you to fill in before your next treatment. This is to keep a record of what happens to you
over the next week before you come back to the hospital. The urology nurse will contact
you the day after your treatment (Wednesday) and discuss any symptoms you may have
experienced.
What happens with my next treatment?
Before leaving the hospital you will be given your next appointment date and time.
You will also receive a phone call Monday (the day before) your next treatment is due,
to check your urinary symptoms and your urine test (MSU) results. This will determine
if you can have your treatment the following day.
What should I do when I get home following treatments?
For the rest of the day after your BCG treatment you should:
• Sit on the toilet when you pass urine;
• Pour 2 cups of bleach into the toilet after passing urine. Leave it for 15minutes
before flushing then flush twice (2);
• Wash your hands, penis, vagina, with soap and water after passing urine;
• Wash any clothing that has had urine spilled on it in hot soapy water;
• Soak any damp pads in bleach and seal in a plastic bag before throwing into
rubbish;
• Make sure you drink plenty of fluids to help flush out your bladder;
• Do not have sexual intercourse for 48 hours (2 days) after your treatment;
• Condoms should be used while having sexual intercourse during your course of
BCG and for 6 weeks after your treatment finishes.
What are the side effects I might expect?
• Mild discomfort when you pass urine;
• Passing urine more often than usual (frequency);
• Increased effort holding onto to your urine (urgency);
• You may feel more tired than usual and have a loss in appetite;
• Mild flu like symptoms and a low grade temperature.
What side effects should I report straight away?
• Fever and chills;
• A temperature of 38.5 C or higher;
• Joint pain and muscle aches;
• Vomiting or feeling sick;
• Passing blood in your urine;
• Severe pain when passing urine;
• A skin rash or cough.

Who should I contact?
You should contact Peter Mac Callum switch board Mon-Fri 8.30am-5pm
Ask to speak to Urology Registrar/Urology Nurse 9656-1111 pager 7406
If out of hours go to the nearest Hospital Emergency Department
What happens when my treatment course is finished?
You will be given an appointment to see your doctor about 6-8 weeks after your last
BCG treatment. At this appointment you will have a ‘check cystoscopy’ so the doctor
can look in your bladder and see how the BCG treatment has worked on the bladder
cancer.
It is important that you keep all your follow up appointments after your BCG course is
finished. You need to have regular cystoscopies so the doctor can assess your bladder
cancer and results can be discussed with you.
Peter Mac Cancer Centre Urology Services, July 2008